How much rates vary
Facilitymedian $3,090 · 10th to 90th $692 to $11,220Professionalmedian $724 · 10th to 90th $138 to $1,122
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $891.25 Median $10,232.93 Typical High $13,803.84 | Facility | None | $891.25 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $2,884.03 | Professional | None | $741.31 | $741.31 | $2,884.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $3,715.35 Typical High $19,054.61 | Facility | None | $1,000.00 | $3,715.35 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,202.26 | Professional | None | $602.56 | $724.44 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $457.09 Typical High $758.58 | Professional | 62 · Two surgeons | $380.19 | $457.09 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $117.49 Typical High $194.98 | Professional | 80 · Assistant surgeon | $95.50 | $117.49 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $102.33 Typical High $169.82 | Professional | AS · PA/NP assist | $83.18 | $102.33 | $169.82 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,548.82 | Facility | None | $794.33 | $1,023.29 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $3,090.30 Typical High $5,248.07 | Facility | None | $549.54 | $3,090.30 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $954.99 Typical High $1,548.82 | Professional | None | $676.08 | $954.99 | $1,548.82 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $3,090.30 Typical High $5,128.61 | Facility | None | $549.54 | $3,090.30 | $5,128.61 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $676.08 Median $954.99 Typical High $1,548.82 | Professional | None | $676.08 | $954.99 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $676.08 Typical High $977.24 | Professional | None | $123.03 | $676.08 | $977.24 |
SummaCare Setting Facility Modifier None Typical Low $1,659.59 Median $1,737.80 Typical High $1,995.26 | Facility | None | $1,659.59 | $1,737.80 | $1,995.26 |
SummaCare Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,071.52 | Professional | None | $707.95 | $707.95 | $1,071.52 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $1,905.46 | Professional | None | $691.83 | $912.01 | $1,905.46 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $371.54 Typical High $1,288.25 | Professional | 52 · Reduced service | $371.54 | $371.54 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $512.86 | Professional | 53 · Discontinued | $147.91 | $147.91 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $1,905.46 | Professional | 54 · Surgery only | $562.34 | $562.34 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $380.19 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $257.04 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $1,778.28 |
Where Ohio sits
The same service costs 6.8 times more in Oklahoma than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Ohio· 49th of 51
$741
OK $3,548TX $525
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.